Immunisation is a nexus controlled by big private vaccine makers, ­mostly ­foreign, that decides your baby gets 15 shots more for the doctor to make ­money. Even if the vaccine is useless—not to talk of the huge mark-ups.

India vaccinates over 27 million newborns every year—a 10 per cent ratio means 2.7 million of them get vaccinated through the private sector. Naturally, in urban areas, the ratio is much higher. “Over 40 per cent of children imm­unised in cities are taken to private hospitals,” says Pradeep Haldar, chairman, Natio­nal Technical Advisory Group on Immunisation (NTAGI), the government body responsible for making suggestions for vaccines to be introduced into the country.

The biggest motivating factor here is the undue mark-ups offered to every intermediary. Studies suggest mark-ups can range from 30-300 per cent. Outlook obtained seve­ral documents from distributors and doctors laying bare the scale inv­olved. Take the pneumococcal conjugate vaccine, administered to prevent pneumonia. It costs the parent Rs 3,800 per dose. And the landed cost of the vaccine, meaning the amount it’s imp­orted for, is only Rs 1,200 per dose. In other words, between distributor and doctor, that’s a neat mark-up of over 300 per cent.

The lack of guidelines and credible regulation, either at the organisation’s level or from the government, is clearly the core issue